Kasabach-Merritt syndrome in infants

Kasabach-Merritt syndrome consists of thrombocytopenia, microangiopathic hemolytic anemia, and an acute or chronic consumption coagulopathy in association with a rapidly enlarging hemangioma. Although the potential for serious morbidity is great, the condition remits when the hemangioma begins to involute. Four infants with large congenital cavernous hemangiomas and Kasabach-Merritt syndrome are described. All four received oral prednisone for variable periods; two received aspirin and one dipyridamole. Two patients required intravenous heparin because of life-threatening disseminated intravascular coagulation and bleeding. Two patients experienced almost total involution of their hemangiomas by the age of 2 years, and one by the age of 13 months. The fourth patient showed signs of beginning resolution of the hemangioma at the age of 8 months and hematologic values returned to normal levels. No side effects from therapy were noted in any of these infants.